… 54 new cases were detected this year 

Younten Tshedup 

The country’s ambitious target to eliminate mother-to-child transmission (MTCT) of HIV is once again under threat as the country detected another MTCT case in the past five months.

This is the first MTCT case detected this year. 

The health ministry has detected 22 new HIV cases (13 male and nine female) including one MTCT case between July and November this year. A total of 54 new HIV cases have been detected so far this year.

Sowai Lyonpo (health minister) Dechen Wangmo said that the two most important goals for Bhutan, in the fight against HIV/AIDS, was to find the missing cases and narrow the detection gap of 39 percent and eliminate MTCT of HIV, Syphilis, and Hepatitis B.

Lyonpo said that the ministry was striving to make people aware of their HIV status through innovative means of HIV testing services and linking the public with quality care, support and treatment.

Launched on World AIDS Day last year, the health ministry has completed the demonstration project to assess the feasibility of HIV Self-Testing (HIVST) in the country. Health officials said that the ministry in its first phase will now launch the programme in six priority dzongkhags targeting high-risk populations.

Despite the successful completion of the HIVST feasibility project, Lyonpo cautioned about the likely risks associated with the self-testing kits in the form of false-negative results, thereby giving people a false reassurance especially during acute infection resulting in insufficient counselling and the possibly delayed entry into care and treatment, if one does not follow the HIVST protocol of the ministry.


The new cases 

Of the 22 new HIV cases detected in the past five months, the majority (12) of them are between the age range of 30 and 39 years. Besides the single MTCT case, the detection pattern (occupation wise) has almost remained the same over the years: Six of them are farmers, five housewives, and five private business operators including two drivers. Others include a monk, a civil servant, and a corporate employee. 

In terms of the mode of transmission, 21 cases had acquired the infection through unprotected sexual activity and one from the mother during birth. Nine of them were diagnosed through medical screening, six each from contact tracing and voluntary counselling and testing, and one during the antenatal care.

Health officials said that all the new cases were put on care and treatment.

Department of Public Health Director, Tandin Dorji said that the ministry was studying the use of suitable rapid test kits which could conduct triple testing of HIV, Hepatitis B, and Syphilis for pregnant mothers.

He said that despite the easy availability of testing facilities in all the health centres including the Health Information and Service Centers (HISC) and private diagnostic centres, the major challenge faced by the ministry was the unwillingness of people to come forward for testing. “We urge our people to avail the free HIV testing and counselling services as it is the only gateway for timely prevention, care and treatment.”

Meanwhile, of the 1,300 estimated HIV cases in the country, only 795 (414 male and 381 female) people have been diagnosed so far since 1993. The missing 505 cases put Bhutan on a 39 percent HIV case detection gap today.

Similar to many other countries in the region, the majority (70 percent) of the reported HIV cases in Bhutan is between the age range of 25-49 years indicating that HIV primarily affects the most economically productive age groups. About 94.2 percent of the infected have acquired HIV infection through sexual route, five percent from Mother-to-Child Transmission (MTCT), 0.4 percent from injecting drug use and 0.4 percent from a blood transfusion.